The development of biomedical technology has introduced new ethical
questions and has sharpened some old ones. It is not obvious that old ways of formulating
Christian ethics are adequate to deal with these questions. I first sketch two approaches:
(1) "code ethics," and (2) "situation ethics," and point out
some of their limitations. My main purpose is to consider bioethics in the context of chiasmic
cosmology , which views the universe in terms of Luther's theology of the cross. This
emphasizes the biblical understanding that God's work is characteristically done with the
appearance of weakness, hidden under the form of its opposite.

Chiasmic cosmology is presented, and some of its general
implications are drawn out. In this setting, I then look briefly at abortion, the use of
life support systems, and genetic engineering as representative issues of bioethics.

Introduction

The development of science and technology almost automatically carries
with it new ethical questions and challenges to some traditional ethical presuppositions.
This is because such development creates new possibilities for human action. In the
biological-medical area, such things as genetic engineering, organ transplants, or
maintenance of bodily life for those who are brain-dead simply were not possible when
traditional ethical systems were formulated, and it is not obvious a priori
that those systems will be able to deal easily with the questions which new
practices raise.

Perhaps traditional ethical concepts will be found adequate, but in a
time of rapid change and new concepts it is wise to examine our foundations. The purpose
of this paper is to look at the fundamental ideas which should undergird Christian ethics,
especially with regard to bioethics.

I will look briefly at two broad approaches, "code ethics"
and "situation ethics," and will note some of the difficulties they have in
dealing with questions introduced by modern biology. As one solution to the problem, I
suggest adoption of a view of the universe which sees the Creator present first of all as
the crucified One - chiasmic cosmology. With this approach, bioethics can also
be kept closely in touch with other areas of the science-theology dialogue.

Approaches to Ethics

Of course the literature on ethics in general, and on Christian ethics
in particular, is vast.1 Here we will only look
quickly at two other approaches before focusing on that associated explicitly with the
theology of the cross.

The oldest and simplest approach refers ethical questions to an
authoritative moral code, so that we may speak of code ethics . In the
Judeo-Christian tradition the Ten Commandments would form the core of such a code. Any
serious type of Christianity has seen the Ten Commandments as an important part of divine
revelation, though different parts of the Christian Church have often been in disagreement
over the role of this code, from Paul and the Judaizers in Galatia to the present day.

Ethics based on the Ten Commandments can be simple and straightforward.
"Thou shalt not kill" - no ifs, ands, or buts. We have an unambiguous apodictic
law.

But application of the commandments is not always straightforward, as
has long been recognized. What am I do to if I can save one person's life only by killing
another? What if I can keep one commandment only if I violate another? "Thou shalt
not kill" is not regarded in the Bible as an absolute prohibition against all taking
of human life, for killing in war and self-defense is sometimes seen as legitimate.

What do the Ten Commandments tell us in the case of a pregnant woman
with uterine cancer whose life can be saved only by the removal of the uterus, with
consequent death of the fetus? If one believes that the fetus receives some protection
from the Fifth Commandment2 then there is no way to avoid
violating this precept.

This is simply a modern version of an old ethical dilemma, and could be
dealt with by various types of argument. But modern biology raises other issues to which
it is hard to see even how to apply the moral code. It does not answer such questions as:

When does the fetus become a person?

When does death occur?

Should we alter the genetic makeup of a human being?

And this is hardly surprising. Such things as genetic engineering were
not even imagined by ancient Israel. Noting this fact involves no denigration of the
authority of the Ten Commandments, but we do have to recognize that the ethical codes of
the Bible do not give explicit answers to all the questions which face us.

Not all the laws in the Pentateuch are apodictic. There are many
casuistic "If - then " formulations, such as those found in Exodus 21-23. But
while these refer to particular situations, they still apply a code to those situations.
It is a much more radical departure from code ethics that has come to be called situation
ethics .3 With this approach there is no appeal to an
authoritative code like the Ten Commandments. What is wrong in one situation - ending a
human life, sexual intercourse, etc. - may be right in another. One must decide how to act
in each concrete setting, guided by the need to show loving concern in that situation.

Certainly love is to be a fundamental element in Christian behavior.
Jesus gave the "new commandment" to love one another (John 13:34), and St. Paul
says that love of neighbor is the fulfillment of the law (Galatians 5:14). But who are all
the people to whom love is to be shown? How is love to be put into practice? (Our concern
for another person's welfare will, for example, be shown in different ways depending on
whether or not we believe that there is any hope for life after death.) There must be
something to guide the application of love in different situations. Without such guidance,
situation ethics could degenerate into a disconnected series of arbitrary responses.

My purpose here is neither to try to eliminate the Ten Commandments as
authoritative guides nor to deny that responsible behavior must to some extent be
situational. We do want to look in a different way at the basic Christian understanding of
God's relationship with the world in order to see how we are to relate to God and to the
rest of the world. The picture of God as the divine lawgiver is neither the most general
nor the most profound Christian image of the way in which God deals with the universe, and
it does not give the clearest answers to some of our basic questions. If our questions
are, "What does it mean to be human?" and "How are we to treat other human
beings and the rest of creation?" then our answers must be informed by the Christian
understanding of who the human par excellence is ( Ecce homo
), and by the way in which God deals with the creation.

Chiasmic Cosmology

How does God deal with the world? God's typical manner of working is
hidden or disguised . God's good work is done under
the form of its opposite. God Almighty says, "My strength is made perfect in
weakness" (II Corinthians 12:9). This takes place throughout the biblical story,
which comes to a head in the cross of Christ. The cross is the characteristic sign of
God's work.4

Only God's revelation is able to show us that God is active in this
cruciform work, for sinners, cut off from God, assume that God Almighty must work in ways
which they consider appropriate for omnipotence. Luther summarized this
fundamental distinction by speaking of "the theology of the cross" and "the
theology of glory.5

That person does not deserve to be called a theologian who looks
upon the invisible things of God as though they were clearly perceptible in those things
which have actually happened. (Romans 1:20)

He deserves to be called a theologian, however, who comprehends
the visible and manifest things of God seen through suffering and the cross.

A theologian of glory calls evil good and good evil. A
theologian of the cross calls the thing what it actually is.

This fundamental insight which comes from the cross and resurrection of
Christ is especially important for us today as our understanding and control of the
universe continue to grow. It tells us how we are to discern God's presence in that
universe which we explore, and thus provides a distinctive answer to the problem of
natural theology. Using imagery from Plato and St. Justin Martyr, I have called this
approach, which sees God "placed crosswise in the universe," chiasmiccosmology.6And it is chiasmic cosmology which, I
believe, should be the context for our considerations about bioethics.

Before examining some specific illustrations, I will spell out a few
general implications of the theology of the cross. These will be helpful in our later
discussion.

First, it should be emphasized that God generally
acts in this crosslike way, and not only in the death of Jesus of Nazareth. That is the
focus of God's work, to which all else is connected. Creation "in the
beginning," biological evolution through natural selection, the Exodus, virginal
conception, the justification of sinners, and the hope of resurrection all bear the mark
of the cross. Romans 4 is especially relevant here.

This shows that God can and does bring good out of evil, life out of
death, and joy out of suffering, because God is the One who creates ex nihilo
. God's work is accomplished in spite of the lack of creaturely possibility.

God identifies with the weak and the helpless. This is quite literally
the case in the Incarnation. The Son of God takes on existence as an embryo, as a refugee,
as one who is persecuted. He is identified with sinners, suffers, and dies. In recounting
the healing ministry of Jesus, the Gospel of Matthew interprets it as part of the
fulfillment of the Suffering Servant prophecies of II Isaiah: "He took our
infirmities and bore our diseases" (Matthew 8:17; cf. Isaiah 53:4). The healer is not
described as one who stands outside the process of suffering, but as one who is effective
through participation in it.

There is one more point which is important in decision making. God's
justification of the ungodly is the same type of creatio ex nihilo which is
seen in the cross and resurrection of Christ (cf. Romans 4:5 & 17). A theology of
glory is likely to assume that a person's value depends upon that person acting according
to certain ethical standards, so that status before God would depend upon behaving
virtuously. That is, of course, the basic idea of "works righteousness,"
standing in antithesis to the doctrine that one's status depends entirely on being
forgiven by God and clothed with the "alien righteousness" which comes through
Christ and is received by faith.

Before we make any moral decisions at all, we are accepted by God. When
confronted with hard choices, it is necessary to pray and study for guidance to decide
wisely. In the medical field such decisions cannot be taken lightly, for they are often
literally life and death decisions. But Christians are free to finally go ahead and make
decisions without having the assurance that they are right. They need
not be paralyzed and rendered helpless by a need to be right. Christians can be confident
that they are God's people whether they made the right decision in a given case or not. We
are not justified by our correct choices, but by the death and resurrection of Christ.

Some Problems of Bioethics

Chiasmic cosmology does not provide a precise calculus for the solution
of ethical problems, but we have just made the point that even to expect such a moral
calculus would be to lapse into a theology of glory. In any given setting, the guidance of
the moral law and the needs of the people involved must be taken into account. But if the
situation is viewed in the light of the cross, we may be helped to see the will of God in
ways that appeals to the Decalogue or to love might not reveal.

Abortion

We may begin with the question of abortion. This is not a new issue
introduced by modern medicine,7 but it is a major ethical
problem today, and modern medicine has greatly expanded our understanding of the character
of fetal life.8 The Bible does not explicitly answer such old
and basic questions as those concerning the time of "quickening." Thus, it has
not been uniformly held in the Christian tradition that life begins at conception.

But we receive a fundamental insight from the classical doctrine of the
Incarnation. Against all adoptionist ideas, this holds that there never was an independent
human person in Jesus Christ. The personal centering of both his human and his divine
nature is the person of the Logos . From the time that he was conceived,
the One borne by Mary was the Son of God (Luke 1:26-45, Matthew 1:20-21).

Fetal life is certainly not full, complete human life. It is human life
at its weakest and most helpless. And the Incarnation shows that the biblical God who is
especially concerned for the poor, for the fatherless and the widow (Psalm 68:5),
identifies precisely with human life in its weakest and most helpless state.

This means, at the very least, that we are to be concerned about the
life and welfare of the unborn. It does not imply that the fetus has an absolute right to
life which overrides concerns about the mother's health. But it does mean that a woman's
right to control her body cannot be absolutized at the expense of the fetus.

Life-Support Systems

At the other end of life, concerns about the appropriate use of
life-support systems, "death with dignity," "right to die,"
"quality of life claims," and euthanasia loom large. Medical technology has made
it possible to maintain body functions in many cases long after there is any possibility
of a return to conscious life. Voices are being raised in the medical community in favor
of allowing, or even facilitating, death in some cases when life could be maintained.9 What does the theology of the cross have to tell us about such
concerns?

As we might expect of a rather broadly defined theology, it will not
always give precise "Yes" or "No" answers in specific cases. But it
will suggest some boundaries for ethical practice.

In the light of the cross, suffering is not a pointless evil, even when
we are unable to see any hope for health or life. This is precisely the meaning of the
resurrection of Christ that the cross, which to ordinary understanding seems foolish, is
the way in which God brings hope (I Corinthians 1:18-31, Romans 4:18). The cross is the
instrument by which God defeats evil (Colossians 2:15). Suffering is therefore not
something to be avoided at all costs. In some cases we are able to see the point in
suffering, and we may then speak of discipline or of the building of character. Then there
is some commonality between Christian and, for instance, stoic ethics. But the theology of
the cross goes deeper. Even when we feel no hope and do not see how anything good could
come from suffering, even when suffering is purely evil, God is able to bring forth good.

Of course we are to try to minimize suffering. But any "quality of
life" ethic which would end life when suffering and loss of dignity have become too
great has failed to grasp the redemptive power of the cross.

That stands as a warning on one side. Our theology also insists that
maintenance of physical life for as long as possible is not the highest good: Those who
love their life lose it (John 12:25). Such attempts may become ways
of denying that ultimate hope comes from the God who raises the dead, just as much as
giving up on life because of suffering or apparent pointlessness may be a denial of hope.

This implies a relatively conservative and apparently "common
sense" approach: To sustain life, but not take "extraordinary" measures
when medicine can foresee no recovery. If there is a strengthening of public and
professional opinion in favor of various degrees of euthanasia, such an approach may not
remain common sense. It is therefore important that witness to the cross of Christ, which
is anything but common sense (I Corinthians 1:18-31), be heard here.

Genetic Engineering

In areas of bioethics, which are still in a more speculative state, it
will not be so easy to see implications of the theology of the cross. This is the case
with human genetic engineering.10 Again, our comments must be
restricted to suggestions of some fairly vague boundaries for deliberate genetic
modification of human beings.

The identification of God with the weak and despised, "the form of
a slave" (Philippians 2:7), reminds us, as we work to eliminate manifest genetic
defects, that we must not be contemptuous of present-day people who have them. It would be
a great advancement to be able to correct the problem of the extra chromosome which
produces Down's syndrome, but it is wrong in the meantime to imply that those who have
this condition should be looked down upon11 We must even be
careful of words like "defect." To speak of people as "defective"
suggests that they are to be regarded as products of a factory, or as merchandise.

When we speak of genetic modification of humans, we are considering
alterations in the evolutionary trajectory of what is now the human race. How is this to
be understood theologically?

Human evolution has already been radically redirected by the
Incarnation, in which humanity is united with God. Of course this is something which
transcends ordinary genetics, but it is not separate from genetics. All human beings are
to some extent "infected" with the divine character of the Word. While human
nature is not destroyed or swallowed up in this union, it is transformed. What it means to
be fully human is not to be understood only in terms of a static concept of human nature,
but must take into account the dynamic character of God's re-creative work in the
Incarnation. And just as other techniques of science and technology may serve as
instruments of God's action, so may genetic modification of the human gene pool.

But the Bible already has something to say about the future of
humanity's evolution. That future is what St. Paul calls the Body of Christ, the
super-personal organism of Christian believers who have Christ as their head (Romans
12:4-8, I Corinthians 12:12-31, Colossians 1:15-24, Ephesians 1:15-23). J.A.T. Robinson
connected Paul's concept with his experience on the Damascus road: When Christians are
persecuted, Christ is persecuted (Acts 9:4)12It was one of
the great achievements of Teilhard de Chardin to put this Pauline concept in an
evolutionary setting with his argument that the Body of Christ is the next stage of human
evolution.13

The direction of humanity's evolution, in this view, is not toward some
type of individual superhuman, but toward the organic community of the Body of Christ. It
will be appropriate to use our technology to correct genetic damage and perhaps even to
work for positive genetic improvements though we always have to ask, "Who decides
what is an improvement?" and Quis custodiet ipsos custodes? But
this activity can be seen as coherent with God's work as a genuine activity of
"co-creation" only if it is in accord with God's will for creation.14
And we have seen that that will of God is revealed most clearly in the cross and
resurrection of Christ, leading to a renewed creation centered on the Body of Christ.
There are certainly dangers associated with human genetic engineering, but it has the
potential to be one instrument of the divine renewal of creation.

A Concluding Comment

We have seen here some examples of how chiasmic cosmology can deal with
questions in bioethics. It is appropriate for Christians to have modest aims for their
theologies, which at best provide models to express the richness of the Christian faith.
It is not necessary that any given theological viewpoint provide a "theory of
everything" (if we may borrow a term now popular in physics). It will be enough
if a theology can provide a coherent and instructive way of understanding a significant
part of our experience in connection with the Christian faith. It seems clear that the
theology discussed here is able to do that.